National Institutes of Health Usage and Attitudes Study.

National Institutes of Health Usage and Attitudes Study

2

Key Questions

Are health information seekers aware of NIH’s research mission? If so, to what degree?

How satisfied are health information seekers with the quality of NIH health content?

How satisfied are health information seekers with the breadth and depth of health topics covered by NIH?

Do health information seekers have different expectations for the NIH Health Information Pages than they do for commercial health Web sites?

What is the context and relationship of the NIH Health Information Pages to other major health resources on the Web?

Do health information seekers have differing expectations for coverage of individual health topics?

Is there a higher degree of satisfaction with content quality for health information seekers who understand the NIH mission?

Is there a higher degree of satisfaction with the breadth and depth of health topics covered for health information seekers who understand the NIH mission?

3

Survey Methodology

• Email survey fielded to Nielsen//NetRatings MegaPanel January, 2004

• 35% response rate• Weighted n = 1,095• Data weighted against NetView Health

Category, based on Age, Income and Gender• Clickstream data based on MegaPanel usage

behavior October, November, December, 2004

4

Agenda

• Key Findings

• Online Health Market Overview

• Health Website Trust Factors

• NIH Visitor Profile

• The NIH “Message”

• NIH Content Quality

• Potential Next Steps

5

Key Findings

• Trust is clearly a key component to which sites consumers visit for health content. Because trust and brand awareness are so closely linked online, it is likely that NIH could increase visitors trust of their content simply through online brand awareness campaign.

• Since health visitors find new sites mostly through search engines and links from other respected sites, it may be most effective to develop deeper partnerships with respected health related sites to further develop brand awareness. Additionally, paid placement on search engines may be a relatively quick and effective way of building awareness and traffic.

• Clearly, building traffic should be a key goal for NIH, users who have visited NIH in the past month have a significantly better opinion of the quality of NIH content and have a much better understanding of NIH’s core message. Since consumers who have not visited NIH recently tend to look to non-search online advertising as a way to find new health sites, NIH may be able to reach this new audience through targeted ad buys on relevant health sites.

• NIH is doing an adequate job conveying it’s message to health content consumers. Improving the messaging is key for long-term success of NIH.gov. Visitors who understand the message are much more likely to be satisfied with NIH and their behavior also suggests they use the content more often and more effectively.

• NIH should also look to improve content quality in specific target areas. Overall site quality lags far behind WebMD. Specifically, NIH should improve it’s arthritis, stroke, hearing loss and diabetes content in order to meet health consumer demand.

6

Online Health Market Overview

• Beyond WebMD, the consumer health market online is extremely fragmented. When given an open ended question and asked to list which health content providers they visited in the past 30 days, 73% of respondents listed health sites that were listed by fewer than 9 other respondents.

• Not surprisingly, WebMD resonates most with visitors, with 91% of their visitors remembering they had visited the site in the past 30 days. Only 50% of NIH visitors remember their visit.

• Site design is seen as not important to health site visitors. This matches well with data from other verticals, which suggest that visitors have come to expect a minimum level of design quality on professional sites. Significant advances above that design tend not to be seen as critical.

• The more common the condition, the more frequent the search. Health category users tend to search for more common ailments, while SIDS and Schizophrenia tend to be searched for less often.

• Search engines and links from sites and online articles are the most popular way to find new health content. Only about 20% of Health category users say they find new content through online advertising, suggesting key word buys on search engines may be a more effective way of advertising health content than other types of traditional media buys.

7

Health Category Usage Metrics

0

500

1,000

1,500

2,000

2,500

3,000

3,500

0

5

10

15

20

25

30

Unique Visitors

Average Minutes Spent

NetRatings NetView run of selected heath sites. January 2005

8

Beyond WebMD Online Health Content Is Fragmented

76%73%

12%10%

3% 3% 3% 3% 3% 2% 2% 2% 1% 1% 1% 1% 1% 1% 1% 1% 1%

Oth

er

We

bM

D

Ya

ho

o! H

ea

lth

NIH

Ma

yo

Clin

ic

CD

C

Me

dc

o H

ea

lth

Go

og

le

Me

ds

ca

pe

Me

dlin

e

MS

N H

ea

lth

Am

eric

an

Ca

nc

er S

oc

iety

AO

L H

ea

lth

Pu

bM

ed

Am

eric

an

He

art

As

so

cia

tion

Dr. W

eil

Ae

tna

dru

gs

.co

m

eM

ed

icin

e

FD

A

Wa

lgre

en

s.c

om

Q: In the spaces below please list the health related websites you have visited in the past 30 days.

NetRatings MegaPanel Survey (2/05) n = 1,095

9

Approximately 50% of NIH’s Visitors Forget That They Have Visited NIH.gov

4%6%

12%13%14%14%

17%29%

38%39%

44%45%

50%51%

59%64%

77%91%

medicinenet.com

About Health and Fitness

QualityHealth

kidshealth.org

healthboards.com

iVillage Health

Mercksource

drugstore.com

Heartcenteronline.com

eMedicine

Yahoo! Health

Pfizerforliving

NIH.gov

Mayo Clinic

AOL Health

MedScape

Medco

WebMD.comMetric: Memory gap analysis shows the percent of visitors who visited a site in the past 30 days that remember visiting.

NetRatings MegaPanel Survey (2/05) sample varies by site

10

Appearance and Diagnosis Are Not Important Factors

92%

92%

95%

90%

93%

68%

90%

32%

95%

Information is easy to find.

Information is written in a way that I can understand.

Information is up-to-date.

The site provides comprehensive information abouttreatments.

The site provides comprehensive information aboutsymptoms.

I can use this site to figure out why I am not feeling well.

Information is relevant to me.

I like the way the site looks.

I trust that the information comes from a reputablesource.

Important>><<Not Important

2%

29%

2%

10%

2%

2%

1%

2%

2%

Q: When you use a site to research health topics, what is important to you? Please rate the following characteristics on a 1 to 5 scale, where 1 means "Not important" and 5 means "Very important."


11

Common Chronic Conditions Are Searched For Most Often

1%4%4%4%4%4%

5%6%

12%18%

21%22%

23%25%

30%

20%None Of The AboveSIDS

Drug AbuseHIV/AIDS

SchizophreniaAlcoholism

GlaucomaInfertility

Learning DisabilitiesAsthma

Acid RefluxDiabetes

Chronic PainArthritis

High Blood PressureAllergies

Q: Which of the following health topics have you researched online in the past 6 months?


12

Search Engine Placement and Site Partnerships Draw in New Visitors

4%4%

1%3%3%

6%6%

8%11%12%13%13%14%15%15%16%

18%19%

21%24%

26%41%

61%

None of the aboveOther

Outdoor advertising Radio program

Radio advertisementNon-“MD” medical professionals

Television programs for entertainment Educational television program

Doctor who specialized in specific conditions Primary Care Physician

General consumer magazines articles Specialized health magazines

Print advertisement Friend/Family - health care related field

Friend/Family - non-healthcare related fieldTelevision advertisements

Television news programs Newspaper articles

Online advertisementsLinks from a personalized homepage/portal

Online articles Links from health sites I already used

Search engine

Q: In The Past Six Months, Which Of The Following Ways Have You Found Out About Websites?


13

Health Website Trust Factors

• 73% of Health category users trust WebMD for specific content they are looking for. 53% would trust NIH. Given the difference in overall brand recognition this difference is not shocking, and is likely not related to the overall quality of NIH’s content.

• NIH’s goal of being a source for information on specific conditions that are being actively researched does seem to resonate with the respondents, with 73% trusting NIH for content on HIV/AIDs and 67% trusting NIH for Schizophrenia content.

• Visitors do not necessarily look to the same site to provide all of their health related content. For example, visitors look to pharma sites for conditions related to specific drugs, portal sites for asthma or government sites for hearing loss.

14

WebMD Is By Far The Most Trusted Health Information Website

76%

53%

43%

27%22%

WebMD NIH.gov Non-NIH.gov or.Org Sites

General PortalsHealth Site

PharmaceuitcalCompanyWebsite

Q: Which of the following sites' research would you trust for the health topics you selected?


15

Broadly, NIH’s Goal of Covering Research “Medical Condition” Seems To Be Met

33%43%

47%47%48%

50%51%52%52%53%53%53%54%

59%61%61%

63%67%

73%

Drug AbuseSchizophreni

SIDSChronic Pain

AlcoholismAcid Reflux

AsthmaHigh Blood

InfertilityArthritis

DiabetesAllergies

Hearing LossStroke

Skin CancerLearning

GlaucomaAlzheimer's

HIV/AIDSQ: Which of the following sites' research (NIH) would you trust for the health topics you selected?


16

WebMD Is Highly Trusted Across The Board

59%62%

66%69%

71%72%72%

76%78%78%78%

80%80%

82%83%84%

86%88%89%

Learning DisabilitiesGlaucoma

AlcoholismHIV/AIDS

Hearing LossSIDS

StrokeAlzheimer's Disease

SchizophreniaDiabetes

Skin CancerAcid Reflux

AsthmaArthritis

Chronic PainDrug Abuse

AllergiesInfertility

High Blood PressureQ: Which of the following sites' research (WebMD) would you trust for the health topics you selected?


17

Broadly, WebMD’s Coverage is Seen As More Trustworthy Than NIH

-51%-37%

-36%-36%-35%

-33%-30%-29%-29%

-25%-25%

-18%-17%-17%

-13%-9%

1%2%

4%

Drug AbuseHigh Blood

Chronic PainInfertility

SchizophreniaAllergies

Acid RefluxArthritisAsthma

DiabetesSIDS

AlcoholismHearing LossSkin Cancer

StrokeAlzheimer's

GlaucomaLearningHIV/AIDS

Gap analysis measures the difference of WebMD from NIH. Negative values show the number of NIH percentage points below WebMD. Those values that are positive show the number of NIH percentage points above WebMD.

Metric: Gap analysis between NIH and WebMD trust.


18

Beyond Glaucoma, Users Have Little Trust For Pharma Sites

2%9%9%

11%12%

17%19%

20%22%

23%24%24%

26%26%

28%31%

34%36%

47%

Drug AbuseAlcoholism

HIV/AIDSHearing Loss

SIDSLearning

Alzheimer's DiseaseSchizophrenia

ArthritisStroke

AsthmaChronic PainSkin CancerHigh Blood

AllergiesDiabetesInfertility

Acid RefluxGlaucoma

Q: Which of the following sites' research (Pharma) would you trust for the health topics you selected?


19

NIH Attracts Visitors Through HIV/AIDs and Alzheimer’s Searches

10%11%11%11%11%

14%14%

15%16%16%

17%18%

19%20%20%

23%24%

32%45%

InfertilitySIDS

Acid RefluxDrug Abuse

GlaucomaHigh BloodAlcoholism

Hearing LossAllergiesArthritis

SchizophreniaDiabetes

Chronic PainStroke

AsthmaLearning

Skin CancerAlzheimer's

HIV/AIDS

Q: Which of the following sites (NIH) did you visit to research the health topics you selected?

NetRatings MegaPanel Survey (2/05) sample varies by condition

20

WebMD Attracts Users Looking for Multiple Health Topics

42%47%

58%62%

64%65%66%67%

69%70%70%70%71%

73%75%76%77%78%

81%

Learning DisabilitiesHIV/AIDS

AlcoholismInfertility

Hearing LossGlaucoma

SchizophreniaArthritis

Drug AbuseStroke

Acid RefluxSkin Cancer

DiabetesChronic Pain

AllergiesAsthma

Alzheimer's DiseaseHigh Blood

SIDSQ: Which of the following sites (WebMD) did you visit to research the health topics you selected?


21

General .gov and .org Sites Attract Visitors Looking For Cognitive Disorders

18%19%

20%20%

21%21%

26%27%27%27%

29%29%

30%30%

34%41%

46%62%

66%

Acid RefluxAllergies

Chronic PainHigh Blood

AsthmaInfertilityArthritis

DiabetesSkin CancerAlzheimer's

SIDSGlaucoma

StrokeDrug Abuse

HIV/AIDSAlcoholism

Hearing LossLearning

Schizophrenia

Q: Which of the following sites (.gov/.org) did you visit to research the health topics you selected?


22

Pharma Company Sites Attract Users Looking For Product Specific Information

0%2%

5%5%

7%8%8%

9%9%

10%11%

12%13%

14%15%

16%20%20%

25%


Hearing LossLearning

GlaucomaSIDS

StrokeInfertilityHIV/AIDS

SchizophreniaChronic PainSkin Cancer

Alzheimer's DiseaseAsthma

AllergiesArthritis

DiabetesHigh BloodAcid Reflux

Q: Which of the following sites (Pharma) did you visit to research the health topics you selected?


23

Visitors Go to General Portals To Find Widely Available Information

11%17%

19%19%19%19%

23%23%

24%24%

25%26%

28%29%

30%34%34%34%

44%

SIDSHIV/AIDS

GlaucomaStroke

Skin CancerAlzheimer's Disease

DiabetesAllergies

Drug AbuseAcid Reflux

Chronic PainHigh Blood Pressure

SchizophreniaHearing Loss

Learning DisabilitiesAsthma

InfertilityArthritis

AlcoholismQ: Which of the following sites (General Portal) did you visit to research the health topics you selected?


24

Conditions With Greatest Gaps In Trust

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

Asthma Hearing Loss Infertility SIDS Schizophrenia

NIH

WebMD

Pharma

GOV

Portal

Percen

t Health U

sers Who

Trust S

ite

25

NIH Visitor Profile

• In general NIH users tend to find health content similarly to the online population, however, they are less likely to click through internet advertisements than other groups. Since almost a quarter of health content users who have not visited NIH do look to online advertising to find out about new health content, traditional online advertising (i.e. banner ads etc.) maybe an efficient way to tap into a new audience.

• Overall, NIH users have higher expectations for the health sites that they visit than non-NIH visitors. They are less likely to find self diagnosis and site design important.

• Visitors who believe that NIH’s content is less than optimal, also tend to visit Yahoo! Health more. This skew reinforces the fact that NIH is successful in their mission in presenting higher quality content, rather than the syndicated content of Yahoo! Health.

• NIH visitors tend to research more topics than non-NIH visitors. Non-NIH visitors tend to research acid reflux and high blood pressure more than NIH visitors. Visitors who research these two areas appear to be using Pharma sites for researching these areas.

26

Almost A Quarter of Non-NIH Visitors Look To Online Advertising As A Means To Find Out About New Health Sites

20%

72%

36%

30%

19%

24%

27%

30%

59%

15% 22%

Doctor who specialized in specific conditions

Search engine

Online articles

Newspaper articles

Educational television program

Specialized health magazines

Friend/Family in a health care field

Primary Care Physician

Links from health sites I already used

Online advertisements

NIH Visitor

Non-NIH Visitor

NetRatings MegaPanel Survey (2/05) NIH Visitor n = 193, Non-NIH n= 901

27

NIH Visitors Are Less Interested In Aesthetics and Diagnosis

95%

94%

65%

93%

94%

98%

96%

23%

99%

32%

comprehensive informationabout treatments.

comprehensive informationabout symptoms.

I can use to figure out why Iam not feeling well


Information is written in away that I can understand.


Information is relevant tome.


the information comes froma reputable source.

NIH

Non-NIH


28

NIH Visitors Who Are Displeased With NIH Content Visit Yahoo! Health More Often

5%

5%

6%

8%

9%

9%

10%

21%

21%

11%

AOL Health

Yahoo! Health

Mayo Clinic

eMedicine

iVillage Health

Medco

QualityHealth

drugstore.com

WebMD

High Quality

Low Quality

NetRatings MegaPanel Survey (2/05) High Quality n = 496, Low Quality n= 382

Metric 1: Mean of the quality scores for all areas of content coverage

Metric 2: Actual visitation to websites in past 30 days

29

In General NIH Visitors Believe The Conditions Will Have A Greater Life Impact

9%

12%

14%

15%

18%

18%

19%

22%

24%

26%

26%

27%

30%

32%

36%

37%

40%

43%

SIDS

Drug Abuse

Schizophrenia

Learning Disabilities

HIV/AIDS

Glaucoma

Alcoholism

Hearing Loss

Acid Reflux

Alzheimer's Disease

Asthma

Skin Cancer

High Blood Pressure

Diabetes

Stroke

Allergies

Arthritis

Chronic Pain

NIH

Non-NIH

Note: In this study, “life impact” was used as a proxy for importance of coverage


30

NIH Visitors Tend To Research More Topics Than Other Groups

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

SID

S

Infe

rtility

Dru

g A

bu

se

Sc

hizo

ph

ren

ia

Alc

oh

olis

m

Gla

uc

om

a

HIV

/AID

S

Le

arn

ing

Dis

ab

ilities

He

arin

g L

os

s

Sk

in C

an

ce

r

Stro

ke

Ac

id R

eflu

x

Alzh

eim

er's

Dis

ea

se

As

thm

a

Hig

h B

loo

dP

res

su

re

Arth

ritis

Ch

ron

ic P

ain

Dia

be

tes

Alle

rgie

s

Non-NIH

NIH Visitor


Q: In the past 6 months, which of the following subject areas have you researched?

31

The NIH “Message”

• NIH is doing an adequate job conveying it’s message to health content consumers. WebMD is by far leading the industry in its ability to explain to visitors what it’s mission is.

• Understanding of the NIH message creates three distinct groups of health content consumers. Individuals with a low understanding tend to have the lowest level of education and income. Consumers with a high level of understanding tend to be better educated with a higher income. The middle group distinguishes itself by having the youngest audience profile. Additionally, overall satisfaction with the site is strongly correlated with understanding of the NIH mission.

32

NIH’s Message is Clearer Than Most, But Lags Behind WebMD

-6%

-6%

-2%

0%

7%

Pharma Sites

General Portals with Health Content

.Gov or .Org Sites

NIH

WebMD

Success of Mission Metric:

This metric is the percent of users who would trust a site to find the specific health information they were looking for minus those that would not trust the site. Therefore a negative number suggest that more users would not trust a site and a positive number would trust a site.


33

Not All NIH Visitors Are The Same: Understanding The NIH Message

Moderate AgeLower Income

Lowest EducationAverage Gender Split

Oldest AgeHighest Income

Highest EducationAverage Gender Split

Youngest AgeModerate Income

Moderate EducationAbove Average Female

Low Understanding Mid Understanding High Understanding

32% 38% 30%NetRatings MegaPanel Survey (2/05) Low n = 218, Mid n = 261, High n = 207

34

Those Who Understand NIH Best, Do Not Use It For Diagnosis

3%

3%

-3%

-2%

-4%

-3%

2%

0%

-1%

-6%

-3%

2%

2%

3%

3%

-2%

3%

0%

2%

1%

-1%

2%

1%

-1%

-2%

0%

0%

Poor Understanding Moderate Understanding Good Understanding

The site provides comprehensive information about treatments.

The site provides comprehensive information about symptoms.

Information is written in a way that I can understand.


Information is relevant to me.


I trust that the information comes from a reputable source.


I can use this site to figure out why I am not feeling well

NetRatings MegaPanel Survey (2/05) Low n = 218, Mid n = 261, High n = 207

35

Overall Satisfaction is Determined Greatly By Mission Understanding

41%

64%

88%

PoorUnderstanding

ModerateUnderstanding

GoodUnderstanding

Satisfied

Dissatisfied

7%2% 1%


36

Good Understanding Of NIH Leads To More Time on Target Pages

5.4

3.4

4.64.2

2.8

5.7

PoorUnderstanding

ModerateUnderstanding

GoodUnderstanding

NIH Pageviews persession

NIH Durration persession (minutes)


37

NIH Content Quality

• NIH should improve it’s arthritis, stroke, hearing loss and diabetes content in order to meet health consumer demand.

• 63% of health consumers see the quality of NIH’s content level as high. WebMD is the industry leader with 80% of health consumers perceiving it’s content quality as high.

• Recent visitation to NIH.gov significantly effects visitors perception of content quality, with 80% of recent visitors saying the content quality is high.

• Perceived content quality is highly correlated with site usage metrics. Visitors who believe that NIH has high quality content view more pages, take part in more sessions and spend more time on NIH.gov than those who are less satisfied with the content quality.

38

In General, NIH is Meeting The Demands Of The Online Health Population

Allergies

Acid Reflux


GlaucomaLearning Disabilities

Chronic Pain

Diabetes

Alzheimer's Disease

HIV/AIDS

Skin Cancer

Asthma

Infertility

Hearing Loss

Arthritis High Blood Pressure

SIDS

Stroke

Schizophrenia

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

40% 45% 50% 55% 60% 65% 70% 75% 80%NIH Quality Score (Top 2 Box)

Life

Imp

act Sco

re (To

p 7 B

ox)

Mean

Mean

Over Invested

Under Invested

Low Demand

High DemandContent Areas To Focus On

39

Health Content Users Perceive Quality Of WebMD’s Content To Be Significantly Better

NIH WebMD

Very High Quality

High Quality

Low Quality

Very Low Quality

33%

47%

1% 1%2%1%

22%

41%

Metric: Mean of the quality scores for all areas of content coverage

63%

80%

NetRatings MegaPanel Survey (2/05) n = 879

40

NIH Areas On Content Strength and Weakness

-20% -10% 0% 10% 20% 30% 40% 50% 60% 70% 80%

SIDS

GlaucomaDrug Abuse

Schizophrenia

AllergiesInfertility

Acid Reflux

AsthmaStroke

Chronic PainArthritis


AlcoholismHigh Blood Pressure

Diabetes

Skin CancerHearing Loss

HIV/AIDS

Alzheimer's Disease

20% 10% 0%

High Quality of Coverage>><<Low Quality


41

WebMD Areas On Content Strength and Weakness

-30% -20% -10% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90%


Glaucoma

Skin Cancer

Hearing Loss

HIV/AIDS

Alcoholism

SIDS

Drug Abuse

Acid Reflux

Stroke

Schizophrenia

Allergies

Infertility

Asthma

Diabetes

Chronic Pain

Arthritis

High Blood Pressure

30% 20% 10% 0%

High Quality of Coverage>><<Low Quality


42

Recent Visitors Have A Higher Perception Of Quality Than Others

Visited NIH in Past 30Days

Have Not Visited NIH inPast 30 Days

Very High Quality

High Quality

Low Quality

Very Low Quality

19%

37%

1% 1%2%

1%

36%

50%

Metric: Mean of the quality scores for all areas of content coverage

86%

56%

NetRatings MegaPanel Survey (2/05) n = 879

43

Those Who Have Visited NIH See The Content As Much Better Than Those Who Have Not

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Acid Reflux

AlcoholismAllergies

Alzheimer's DiseaseArthritis

AsthmaChronic Pain

DiabetesDrug Abuse

Glaucoma

Hearing LossHigh Blood Pressure

HIV/AIDSInfertility

Learning DisabilitiesSchizophrenia

Skin CancerStroke

SIDS

Visited NIH in Past30 Days

Have Not VisitedNIH in Past 30 Days


44

Perceived Quality Leads To Dramatically Different Content Use

41

18

2

49

5

50

9

50

3

48

5

PageViews

Sessions PageViews

Sessions PageViews

Sessions

Low or Neutral Quality

High Quality

NetRatings MegaPanel Survey (2/05) NIH High Quality n = 548, Low Quality n= 330

NIH WebMD Overall Health Category

45

Visitors Who Believe That NIH’s Content is High Quality Spend 13 More Minutes Per Month

4

16

7

17

30

7

NIH Time Per Month(min)

WedMD Time PerMonth (min)

Health Category TimePer Month (min)

Low or Neutral Quality

High Quality

NetRatings MegaPanel Survey (2/05) NIH High Quality n = 548, Low Quality n= 330

46

Potential Next Steps

• Developing an outreach strategy– Advertising strategy– Partnership strategy

• Refining NIH.gov’s message in a way that better resonates with health content users

• Strengthen arthritis, stroke, hearing loss and diabetes content to meet health consumer demand

Thanks!Jon Gibs

Senior Project Manager

[email protected]

National Institutes of Health Usage and Attitudes Study.

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Transcript of National Institutes of Health Usage and Attitudes Study.